Technical Field
The present disclosure relates to methods of enhancing wound closure in tissue and, more particularly, the use of a surgical fastener having a plurality of reactive members of a specific binding pair, with a liquid precursor having a plurality of complementary reactive members of the specific binding pair, for sealing wounds in tissue.
Background of Related Art
Techniques for repairing damaged or diseased tissue are widespread in medicine. Wound closure devices such as sutures, staples, clips and other devices are frequently used to close wounds, whether created during the repair process or as a result of the damaged tissue. Even though these techniques are generally well suited to mechanically close a wound in any tissue, some of these techniques add small perforations to the wound tissue during the wound closing process. For example, lung tissue is extremely fragile and does not hold sutures well. That is to say, although sutures are strong enough to generally close a wound in lung tissue, suturing the lung tissue may result in small lung perforations because the lung tissue is so fragile. Such small perforations may allow for the leakage of bodily fluids post-operatively which can lead to post-operative complications, such as infection.
Surgical adhesives such as cyanoacrylates and fibrin glues have been used as fixatives in lieu of suturing or stapling the wound closed. However, these adhesives do not provide the necessary elasticity or mechanically strength often needed to keep the tissue wound closed.
Click chemistry is a popular term for reliable reactions that make it possible for certain chemical building blocks to “click” together and form an irreversible linkage. See, e.g., US Pub. No. 2005/0222427. Since its recent introduction, click chemistry has been used for ligation in biological and medical technology. In the case of azide-alkyne click chemistry, the reactions may be catalyzed or uncatalyzed. For example, copper-free click chemistry was recently developed by Bertozzi and colleagues using difluorinated cyclooctyne or DIFO. that reacts with azides rapidly at physiological temperatures without the need for a toxic catalyst. See. e.g. Baskin et al., Copper Free Click Chemistry for Dynamic In Vivo Imaging, PNAS, vol. 104, no. 43, 16793-16797 (Oct. 23, 2007). The critical reagent, a substituted cyclooctyne, possesses ring strain and electron-withdrawing fluorine substituents that together promote a [3+2] dipolar cycloaddition with azides. See also, US Pub. No. 2006/0110782 and Codelli et al., Second Generation Difluorinated Cyclooctynes for Copper-Free Click Chemistry, J. Am. Chem. Soc., vol. 130, no. 34, 11486-11493 (2008). Another suitable cyclooctyne is 6,7-dimethoxyazacyclooct-4-yne (DIMAC). See, Sletton and Bertozzi, A hydrophilic azacyclooctyne for Cu-free click chemistry, Org. Lett. (2008) 10 (14), 3097-3099. Other click chemistry reactions include Diels-Alder reactions, thiol-alkene reactions, and maleimide-thiol reactions. There is a continuing need to generate improvements in tissue repair technology and advance the state of the art.